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Module 6: Medical and Surgical Asepsis Module 6: Medical and Surgical Asepsis Minimum Number of Theory Hours: 2 Suggested Theory Hours: 5 Recommended Clinical Hours: 8 Statement of Purpose: The purpose of this unit is to present information about asepsis and the control of infection. Procedures and precautions to protect patient/patients/residents, health care workers and others from infection are presented, including standard precautions, transmission- based precautions and biohazardous waste management. Terminology 1. Acquired Immunodeficiency 21. Escherichia coli (E. coli) 40. Non-intact Syndrome (AIDS) 22. Excretions 41. Nosocomial 2. Airborne precautions 23. Exposure incident 42. Occupational Safety and Health 3. Asepsis 24. Flora Administration (OSHA) 4. Athlete’s foot 25. Fungus 43. Pathogens 5. Bacteria 26. Health Care-Associated Infection 44. Personal Protective Equipment 6. Barriers (HAI) (PPE) 7. Biohazard symbol 27. Hepatitis A, B, C, D, E 45. Pneumonia 8. Bloodborne 28. Herpes zoster 46. Precautions 9. Carrier spore 29. Host 47. Protozoa 10. Centers for Disease Control (CDC) 30. Immunity 48. Reservoir 11. Chain of infection 31. Infection 49. Reverse isolation 12. Communicable 32. Infectious agent 50. Rickettsia 13. Contact precautions 33. Influenza 51. Scabies 14. Contagious microbes 34. Isolation 52. Sepsis 15. Contamination 35. Lice 53. Standard precautions 16. Disinfection 36. Material Safety Data Sheet (MSDS) 54. Sterilization 17. Disorientation 37. Methicillin-Resistant 55. Streptococcus 18. Disposable Staphylococcus aureus (MRSA) 56. Transmission-based 19. Droplet precautions 38. Microorganisms 57. Tuberculosis 20. Environmental Protection Agency (EPA) 39. Nausea 58. Vancomycin-Resistant Enterococci (VRE) 59. Virus California Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018 Page 1 of 31 Module 6: Medical and Surgical Asepsis Patient, patient/resident, and client are synonymous terms referring to the person receiving care Performance Standards (Objectives): Upon completion of the two (2) hours of class plus homework assignments and eight (8) hours of clinical experience, the learner will be able to: 1. Define key terminology 2. Name four infectious agents (microbes) and discuss the diseases they cause 3. Discuss two antibiotic resistant bacteria 4. State five conditions necessary for infectious agents to grow 5. Identify the six parts of the chain of infection 6. List four lines of defense against infection in the body 7. Describe the signs and symptoms of infection 8. Differentiate between medical and surgical asepsis 9. Identify the roles of the Centers for Disease Control (CDC) and the Occupational Safety and Health Administration (OSHA) in the prevention of infections 10. Explain standard precaution procedures 11. Describe personal protective equipment (PPE) and proper use 12. Define transmission-based precautions 13. Identify the psychological effects of standard precaution and transmission based precautions on patient/patients/residents California Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018 Page 2 of 31 Module 6: Medical and Surgical Asepsis References: 1. Acello, B. & Hegner, B. (2016). Nursing Assistant: A Nursing Process Approach. (11th ed). Boston, MA. Cengage Learning. 2. Acello, B. (2016). Workbook to accompany: Nursing Assistant: A Nursing Process Approach. (11th ed). Boston, MA. Cengage Learning 3. California Medical Waste Management Act, California Health and Safety Code, Division 20, Chapter 6.1, Section 25015. https://www.cdph.ca.gov/Programs/CEH/DRSEM/CDPH%20Document%20Library/EMB/MedicalWaste/MedicalWasteManage mentAct.pdf 4. Carter, P. J. (2017). Lippincott Essentials for Nursing Assistants: a Humanistic Approach to Caregiving. (4th ed.) Philadelphia, PA. Lippincott Williams & Wilkins 5. Centers for Disease Control and Prevention (2007) Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings https://stacks.cdc.gov/view/cdc/45809 6. Centers for Disease Control and Prevention. (2003). Guidelines for Environmental Infection Control in Health-Care Facilities http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5210a1.htm (No updated CDC source) 7. Centers for Disease Control and Prevention. (2008) Hand Hygiene Saves Lives: Patient Admissions Video Available at https://tools.cdc.gov/medialibrary/index.aspx#/landing/mediatype/Video/language/english/page/1/sort/desc/group/0/query/Hand %2520Hygiene 8. Deck, M.L. (2004). Instant Teaching Tools for the New Millennium. St. Louis: Mosby. 9. Guideline Prevention and Control of Antibiotic Resistant Microorganisms - California Long-Term Care Facilities. Department of Health Services, January 17, 1996. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3375028/ 10. Hartman Publishing (2018). Workbook for Hartman's Nursing Assistant Care: Long-Term Care (4th ed.). Albuquerque, NM. Hartman Publishing, Inc. 11. Haroun, L. & Royce, S. (2004). Teaching Ideas and Activities for Health Care. Albany, NY. Delmar Publishers 12. Hedman, S. A., Fuzy, J., & Rymer, S. (2018). Hartman's Nursing Assistant Care: Long-Term Care (4th ed.). Albuquerque, NM. Hartman Publishing, Inc. 13. Pearson Vue (2018). California Nurse Assistant Candidate Handbook for National Nurse Aide Assessment Program. Philadelphia, PA. Pearson Education, Inc. 14. Sorrentino, S. A., Remmert, L., & and Kelly, R. (2018) Workbook and Competency Evaluation Review for Moby’s Textbook for Nursing Assistants (9th ed.) St. Louis, MO. Mosby Company 15. Sorrentino, S.A. & Remmert, L. (2018) Mosby’s Textbook for Nursing Assistants. (9th ed.). St Louis, MO. Elsevier 16. Sack, K. (2008). Infection control guidelines issued.The New York Times. p A21. Accessed 2/23/09 http://www.nytimes.com/2008/10/09/us/09infection.html?ref=us 17. Standards, Toxic and Hazardous Substances and Bloodbourne Pathogens, 1910.1030. http://www.osha.gov/pls/oshaweb/owadisp.show_document?p_table=STANDARDS&p_id=10051 18. Weaver, L. & Wilding, M. (2013). The Dimensions of Engaged Teaching: a Practical Guide for Educators. Bloomington, IN. Solution Tree Press. California Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018 Page 3 of 31 Module 6: Medical and Surgical Asepsis Recommended Teaching Clinical Demonstration/ Content Outline Strategies and Method of Evaluation Assignments Objective 1 Define key terminology. A. Review the terms listed in the terminology section A. Lecture/Discussion A. Have students select B. Spell the listed terms accurately B. Games: word searches, five words from the list C. Pronounce the terms correctly crossword puzzles, of key terminology and D. Use the terms in their proper context Family Feud, Jeopardy, write a sentence for bingo, spelling bee, each defining the term hangman, and B. Administer vocabulary concentration pre-test and post-test C. Encourage use of C. Uses appropriate internet, medical terminology when dictionary, and charting and reporting to textbooks licensed personnel D. Create flashcards for learning purposes Objective 2 Name four infectious agents (microbes) and discuss the diseases they cause. A. Bacteria A. Lecture/Discussion A. Written test 1. Streptococcus – strep throat, pneumonia B. Share personal B. Class participation 2. E. coli – urinary infections experiences with diseases and identify 3. Tuberculosis – lung disease infectious agent 4. Rickettsia involved a. Lice – itching (body, head and pubic) C. Discuss why the elderly b. Scabies – skin rash might be more prone to B. Virus these illnesses 1. HIV (AIDS virus) – acquired immunodeficiency syndrome D. Discuss possible 2. Hepatitis A, B, C – liver disease feelings about caring for a 3. Common cold – respiratory infection patient/patient/resident 4. Influenza – fever, chills, body aches with an infectious 5. Herpes zoster – shingles disease California Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018 Page 4 of 31 Module 6: Medical and Surgical Asepsis C. Fungi 1. Tinea pedis – athlete’s foot 2. Candida albicans – yeast infection D. Protozoa 1. Malaria Objective 3 Discuss two antibiotic resistant bacteria. A. Methicillin resistant staphylococcus auerus (MRSA) infection A. Lecture/Discussion A. Written test B. Vancomycin resistant enterococcus (VRE) – infection B. Discuss why B. Class participation microorganisms have become antibiotic- resistant Objective 4 State five conditions necessary for infectious agents to grow. A. Food source A. Lecture A. Written test B. Moisture B. Discussion B. Class participation C. Oxygen or lack of oxygen D. Warmth E. Darkness Objective 5 Identify the six parts of the chain of infection. A. Causative agent A. Lecture/Discussion A. Written test 1. Bacteria B. Handout 6.5- Chain of B. Class participation 2. Viruses Infection C. Demonstrate and return 3. Fungi demonstration for 4. Insects passing ice B. Reservoir D. Ask class to identify 1. Patient/resident ways to break the chain 2. Health care worker of infection 3. Environment E. Manual Skills 6.5- 4. Equipment Passing Ice California Community Colleges Chancellor’s Office Nurse Assistant Model Curriculum - Revised December 2018 Page 5 of 31 Module 6: Medical and Surgical Asepsis C. Portal of exit 1. Wound drainage 2. Bodily fluids 3. Feces 4. Blood 5. Respiratory, reproductive and urinary tracts 6. Saliva D. Method of transmission 1. Airborne 2. Droplet 3. Contact (direct and indirect) 4. Food/water 5. Animals/insects E. Portal of
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